Articles

By Dr. Greg Hammer

Sex is an important component of healthy relationships between two people. Sex is front and center for most teens. A majority of teens will have sex with a partner before they graduate from high school, according to the National Survey of Family Growth.[1]Unfortunately, adolescents may engage in sex before they are mentally and physically prepared. While physical intimacy can be a source of meaningful connectedness and confidence for teens, it can also be traumatic. 

Teenage pregnancy can be devastating for those not intending to become pregnant. The majority of teen pregnancies are, in fact, unwanted. Nearly 200,000 teenagers become pregnant each year in the United States. More than 1/3 of these are terminated by abortion. Those that proceed are associated with a variety of challenges. 

Teen mothers are at an increased risk of adverse health problems, including pre-eclampsia, anemia, and preterm labor, often resulting in premature infant births. Even when carried to term, babies are more likely to have low birth weight, potentially leading to long-term health and developmental complications for the child. Premature and low birthweight babies are at risk for having behavioral and cognitive impairment, as well as eventually becoming teenage parents themselves.

Teenage pregnancies, especially among unwed mothers, often occur in areas of the US in which prenatal healthcare and education may be less than ideal. This includes poverty-stricken regions of Arkansas, Louisiana, Mississippi, Oklahoma, and Texas. Poor pregnancy outcomes are correlated with poverty. 

The demands of raising a child among teenage moms are great and often lead to dropping out of school. This may propagate the cycle of limited education, restricted job opportunities, poverty, and undesired pregnancy.

The stress of pregnancy may lead to mental health issues, especially since teens are still developing physically and emotionally. This is commonly exacerbated by social stereotyping from friends and family members, predisposing to poor self-esteem, guilt, shame, and depression. 

Teenage sex may lead to the spread of sexually transmitted diseases (STDs). Unprotected sex among adolescents is common due to predisposition to risk-taking behavior and lack of education about the hazards involved. As a result, millions of teens acquire STDs every year in the US. The most common STD is chlamydia.[2]Around 80% of cases are asymptomatic, so the great majority of those infected would only be made aware via screening. Though the CDC recommends that all sexually active females under the age of 25 undergo annual screening, only a small minority are tested. Unfortunately, chlamydia infection may lead to infertility and painful, chronic pelvic inflammatory disease (PID). 

Genital herpes due to herpes simplex virus (HSV) types 1 and 2 is also common among teens. HSV is highly contagious and can remain latent and potentially reactivated at any time, often due to stress. It can be spread even when the infected individual has no symptoms. 

Another common STD is human papillomavirus (HPV). HPV infection predisposes to cervical, vaginal, and vulvar cancer in females and throat cancer and genital warts in males and females. The HPV vaccine is safe and effective. Pre-teens aged 11-12 years are advised to receive two injections 6-12 months apart, or three shots if not started before age 15.

What can parents do to mitigate the risk of unsafe teenage sex and STD transmission? They can talk openly in a calm, non-threatening, and non-judgmental manner with their teens. They can help educate their teens as to the importance of either abstinence or condom use, making sex as safe as possible. Parents can provide educational materials about pregnancy and STDs. They can encourage and facilitate STD screening. 

By addressing these key issues, parents and other trusted adults can help teens understand the complexities of sex and make responsible, carefully considered choices regarding their sexual health and well-being
   

[1] https://publications.aap.org/pediatrics/article-abstract/131/5/886/31308/Sexual-Initiation-Contraceptive-Use-and-Pregnancy?redirectedFrom=fulltext

[2] Corcoran JL, Li P, Davies SL, Knight CC, Lanzi RG, et al. Adolescent chlamydia rates by region, race, and sex: Trends from 2013 to 2017, J Ped Health Care 2021;35(2);172-9. ISSN 0891-5245, https://doi.org/10.1016/j.pedhc.2020.09.004.

By Dr. Greg Hammer

Allowing versus prohibiting the use of cell phones in schools represents a controversy in the US. While cell phones are useful tools for communication, safety, and learning, they also divert students’ attention away from classroom education. What are the arguments on both sides?

It is well known that cell phone use by students can be very distracting, thereby negatively impacting academic performance. According to a study by the London School of Economics, banning cell phones was associated with more than a 6% boost in test scores (https://cep.lse.ac.uk/_NEW/NEWS/abstract.asp?index=5013). The benefit of banning cell phones seems to be especially beneficial for low-achieving students and younger children in elementary school. 

Another plus in favor of banning cell phones for a significant portion of the week is the associated decrease in exposure to cyberbullying. Limited cell phone use translates to a reduction in the time during the day that teens experience cyberbullying. More than one third of students between 12 and 17 years of age are victimized, with many incidents occurring during school hours (https://cyberbullying.org/2019-cyberbullying-data).

Eliminating cell phone usage during school encourages social interaction. Students who are “addicted” to using their phones have less opportunity for in-person interactions with their peers. In schools in which cell phones are banned, students tend to engage more with each other during recess and lunchtime (https://www.panoramaed.com/blog/how-do-cellphones-affect-students-in-school#:~:text=*%20Lack%20of%20Focus%20on%20Education:%20Studies,may%20prioritize%20quick%20answers%20over%20deeper%20learning.)

For these reasons, banning cell phone use at school appears to contribute to improved mental health among teens.

What about arguments against banning cell phones in school?

Parents are generally reassured knowing they can contact their children (or vice-versa) in case of urgent need, such as security threats in the schools, family emergency, injury, or natural disaster. 

Banning cell phones could disproportionately affect lower-income students who rely on their smartphones to access learning tools – they may not have laptops or tablets. Cellphones serve as valuable learning instruments when properly used. These devices facilitate instant access to research online. Banning them could preclude engagement in interactive learning, problem-solving, and preparation for navigating an increasingly digital world.

Enforcing the banning of cellphones may be challenging for teachers. Middle- and high school students may resist complying with policies limiting or banning cell phone use during school hours.

The decision to ban cellphones at school is not as black and white as it may appear. The benefits include reduced cyberbullying, improved mental health, and less distraction in school. The potential hazards include compromised ability for parents to contact their children in case of emergency and missed opportunities for learning, especially for children of lower-income parents. 

Teachers and school administrators seem to be increasingly in favor of cellphone bans during school hours as evidenced by such policies at a growing number of schools. Several states have enacted laws restricting or eliminating cellphone use at school, including Florida, Louisiana, South Carolina, California, Ohio, Indiana, and Virginia. Many school districts in other states have also jumped on the bandwagon.

By Dr. Greg Hammer

The internet, social media, and smartphones offer many resources for teens – and also a platform for bullies to do harm to our youth. The harassment, threatening, and humiliating via these technologies is called “cyberbullying.” Examples include sending mean emails, texts, or postings and sharing intimate photos on social media platforms. Some cyberbullies have created hate groups of website against an individual or excluding them from an online group.

Which apps are most often utilized for cyberbullying? Instagram is in first place, followed by Facebook and Snapchat.[1]The perpetrators are often unidentifiable and anonymous. 

More than 1/3 of teens have reported cyberbullying – the incidence is likely even greater.[2] 

Cyberbullying takes a variety of forms. Doxxing refers to the exposure of private information intended to humiliate and/or harass its target. This may take the form of posting embarrassing photographs or pages from a diary. Revenge porninvolves posting of intimate images, e.g. from a former boyfriend. AI enhances the ability of cyberbullies to create fake photos and videos that are almost impossible to distinguish from the real thing. 

Another form of cyberbullying is the spreading of malicious rumors that appear to be factual but are often not so.

The damage caused by cyberbullying can be immense and long-lasting. Depression, anxiety, suicidal thoughts, self-harm, and low self-esteem have been documented. The great majority of victims have sadness, powerlessness, and hopelessness.[3]Teen victims are likely to feel isolated. They may suffer physical maladies, including headaches, stomach aches, or insomnia.

A useful helpline for those feeling suicidal is 1-800-273-8255.

For parents, teachers, counselors, and coaches, there are several signs of cyberbullying of which to be aware:

• 1. Withdrawal from social interaction;
• 2. Detachment from friends and family or sports and other activites;
• 3. A drop-off in school performance or refusal to attent school;
• 4. Demonstrative signs of depression, anger, and irritability;
• 5. New onset of physical signs as above.
• What can parents do when their teenagers are cyberbullied? Below are several important considerations.
• 1. Teens are best served by not responding to cyberbullying posts, regardless of how horrific they may be. Replying to posts on social media gives the bullies exactly what they want.
• 2. Parents can ask their teens to save evidence, eg by capturing a screenshot of the post(s). This may help in the prosecution of cyberbullies if they are ultimately caught.
• 3. Parents can help their child report incidents to their school and, if necessary, to the police.
• 4. Teens can block the offender from their cell number or email address if applicable. They can unfriend and unfollow the offender.
• 5. Parents are well-advised to be sensitive to their teens’ feelings and encourage them to talk to a counselor, teacher, coach, or therapist. Discussing their feelings may go a long way to improve their self-esteem.
• 6. Adults can encourage the victim of cyberbullying not to blame themselves. It is not their fault. They can be counseled not to be ashamed or guilty, even in cases where they shared revealing photos or other material via social media that was used to victimize them.

Talking about cyberbullying with pre-teens and adolescents can be extremely valuable. Citing instances in which cyberbullying has led to adverse consequences may enlighten them about the extreme dangers of sharing personal information on social media.

[1] “Ditch the Label,” The Annual Bullying Survey 2017,
https://www.ditchthelabel.org/wp-content/uploads/2017/07/The-Annual-Bullying-Survey-2017-1.pdf

[2] S. Hinduja, J.W. Patchin “Cyberbullying Facts,” Cyberbullying Research Center 2023, https://cyberbullying.org/facts

[3] “Current perspectives: the impact of cyberbullying on adolescent health,” National Library of Medicine 2023, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4126576/